Individual provider Active NPI

Edward Samuel Eusanio, MD

  • Student in an Organized Health Care Education/Training Program
  • Orlando, FL
National Provider Identifier
1740022698
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
52 Underwood St
Orlando, FL 32806-1110
Phone
(321) 841-5145
NPI assigned
Jun 11, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

52 Underwood St
Orlando, FL 32806-1110

Mailing address

1335 Sligh Blvd, 5TH Floor
MP41
Orlando, FL 32806
Phone (321) 841-5145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240717004745 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5395280085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1740022698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 SLIGH BLVD, 5TH FLOOR",
            "address_2": "MP41",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "321-841-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-841-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSANIO",
        "first_name": "EDWARD",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.